• Wednesday April 8,2020


With pathological apathy medicine means a symptom of various diseases characterized by indifference, insensitivity to stimuli and lack of excitability. Most commonly it occurs in people with dementia.

What is apathy?

The apathy is characterized by non-responsiveness, lack of response to all external stimuli, apathy and an apparent numbness.

The apathy is characterized by non-responsiveness, lack of response to all external stimuli, apathy and an apparent numbness. The disorder affects the central nervous system and is a sign of serious illness. Together with the apathy usually depressed, loss of appetite, sleep disorders and changes of judgment occur.

All ages can be affected by apathy, but above all, it is a symptom of advanced dementia and is therefore considered particularly frequent in older people. Approximately 92% of patients with frontotemporal dementia, 72% of those with vascular dementia, 63% of Alzheimer's and 57% of patients with Lewy body dementia show signs of apathy during the course of the disease.

Other common ailments include rabies, pronounced hypothyroidism, and mental illnesses such as autism, severe anorexia nervosa, and depression. If symptoms of apathy in infants can be identified, these are usually due to severe infectious diseases with high fever.


The causes of apathy can not be called general, it must be distinguished according to the underlying disease. The following is a rough overview of the causes of the most important diseases that have apathy as a symptom.

So far, too little research has been done on the triggers of mental illness in order to be able to make concrete statements. One suspects an interplay of innate and social influences. Dementia can be attributed to various causes that are based on underlying diseases, vascular damage or genetic predisposition. However, to date, the causes could not be explored in more detail, only accompanying symptoms are clear.

Rabies is an infectious disease in which apathy is a warning of aggressive phases. It is transmitted to humans through bites of rabid animals and quickly migrates from the wound into the central nervous system. There it triggers first flu-like symptoms and later meningitis, central nervous symptoms such as increased aggressiveness, apathy and hallucinations.

Diseases with this symptom

  • Creutzfeldt-Jakob disease
  • yellow fever
  • cold
  • botulism
  • poisoning
  • heatstroke
  • Adrenocortical insufficiency
  • dementia
  • brain tumor

Diagnosis & History

Apathy manifests itself in the already indicated symptoms of apathy, non-responsiveness and lack of response to lack of stimuli. It is noticeable that those affected always seem absent, no longer make eye contact, no longer eat and drink and sleep disorders are obvious.

If there are signs of apathy, relatives or caregivers should notify a doctor or take the casualty to a hospital. If one considers the diagnosis of apathy as certain, investigations of the cause are necessary. However, it must be said that this is usually already established before the apathy breaks out. Only in rare cases patients suffer from apathy, without a cause can be suspected or this has already been diagnosed in advance.

Extensive tests, blood tests and imaging procedures can be used to diagnose the underlying diseases. Treatment can only be initiated once the cause has been established.

The course of apathy must be differentiated according to the underlying diseases. Thus, in cases of mild infectious diseases with a high fever, good chances of recovery can be stated. In rabies and dementia, however, the prognoses are unfavorable, since until today good treatment methods are missing.


Apathy can lead to a number of mental and physical complications. Thus, the stress associated with apathy can promote diseases of the cardiovascular system. High blood pressure, heart failure or coronary heart disease are the result. It also affects other organs, such as the liver and kidneys, which are particularly susceptible to disease during apathy.

Endocrine thyroid or kidney diseases as well as viral infections are the result of untreated apathy or lethargy. Later on, various infectious diseases such as tuberculosis or chlamydia can be added. Similarly, disorders of the nervous system, which manifest themselves in the form of neurosis, depression or myasthenia gravis and turn out differently depending on the age and constitution of the patient. Finally, an apathy may lead to anemia, ie a lack of blood and concomitant symptoms such as dizziness and feelings of weakness.

Generally, mental and physical well-being diminishes as a result of apathy and thus favors a variety of other complications that are often difficult to attribute to apathy as a cause. The lack of motivation can also lead to malnutrition and thus to the following episodes such as anemia. Patients experiencing apathy should consult a physician as soon as possible to avoid the onset of the multiple complications associated with apathy.

When should you go to the doctor?

If apathetic behavior persists for several weeks, seek medical advice immediately. With a physical lack of energy that lasts for a few days and then spontaneously disappeared, an analysis and background research should be done. If the causes are resolved and resolved due to temporary incidents, it is certainly not necessary to see a doctor.

If the state of lack of interest in normal goals, lack of personal hygiene or the loss of the will to survive for days or weeks, the visit to the doctor is highly recommended. This also applies if the triggering event is known. Often, apathy is only an accompanying symptom of another and possibly more severe illness. If there is a temporary lack of motivation for 2-3 days, it should be noted whether it occurs repeatedly and at what intervals or conditions this occurs.

The symptoms of apathy may be present in parallel with other mental disorders. Only a specialist can make a distinction or estimate the course as expected on the basis of the patient's medical history. If motivation disorders occur as a result of cranial injuries or brain trauma, sufferers must wait to see if the apathetic behavior persists as soon as the injuries have healed. Nevertheless, the doctor should be informed in time to follow the development of apathy and to intervene in time.

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Treatment & Therapy

There is no general treatment for apathy, the underlying disease must be treated.

Mental causes are treated with psychotherapy and possibly psychotropic drugs. It should be noted, however, that most mental illnesses can not be cured, only changed in their course. A more normal life is possible, a cure of all symptoms is therapeutically unlikely.

For rabies also promising therapeutic measures are missing. It must be assumed that the disease is fatal. Although a modern approach to treatment provides for antivirals and simultaneous sedation, this approach was only successful in two cases.

The course of dementia can be slowed down for some time with medication and memory training, but even here a complete cure is not possible.

Outlook & Forecast

The prognosis and prospect with respect to apathy must always be made dependent on the underlying disease. If the apathy is the side effect of a drug treatment, the symptoms usually resolve on their own after the therapy has ended. Apathy as a result of a temporary illness, such as an infection, also promises good chances of healing, inasmuch as the underlying condition is treated quickly and comprehensively.

Indifference in the context of a progressive disease such as dementia, however, is only tedious or impossible to treat. Even apathy as a result of a psychogenic disorder permanent symptoms are likely.

If apathy is based on a rabies disease or other serious viral disease, it leads to severe concomitant symptoms and sometimes even death of the patient. The prognosis and prospect of apathy thus depends significantly on the causative disease, timing and type of treatment.

If the underlying condition is curable, apathy often disappears, but long-term side effects are to be expected in the case of severe infections and psychogenic illnesses. The final prospect and prognosis can therefore only be made by the attending physician due to the many influencing factors.


The apathy can not be prevented, only a few underlying diseases with specific measures.

You can do that yourself

In an apathy, various immediate measures can help. First of all, it is necessary to balance the emotional emptiness with a fulfilling everyday life. Patients can alleviate the symptoms through a clearly structured daily routine with a fixed stand-up time and scheduled tasks. The feeling of indifference can only be remedied by self-initiative. In some cases, simple goals such as meeting a friend or interviewing are enough to generate the necessary motivation and gradually alleviate apathy.

Those affected should generally entrust themselves to a friend or family member, as mentioned coping strategies can be more easily implemented with support. In addition, general measures such as adequate exercise, a balanced diet and the absence of stimulants help to relieve concomitant symptoms such as fatigue and tiredness.

If apathy occurs as a result of schizophrenia or depression, talking to a psychologist or psychotherapist can help clarify the symptoms and help them overcome them. If the apathy persists for several days, a doctor must be consulted, as the symptoms are then often based on a mental illness such as burn-out, which is not self-treating.

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